[Show abstract][Hide abstract] ABSTRACT: Urinary incontinence (UI) is considered a public health problem that should be firstly approached in the primary care units (PCU). Educational programs target to professionals who work in these units are a key component in the management of this condition. The aim of this study was to report the experience of the "Caring for Who Cares", a project developed in a PCU aimed at educating employees about UI. The educational program was carried out as a dynamic, with theoretical and practical character, lasting 2 hours. The 28 participants were divided into 2 groups. Each group participated in the program on different days so that the usual activities of the PCU could be maintained. Issues such as types of UI, risk factors, preventive and therapeutic measures, especially urinary and bowel habits and pelvic floor muscle (PFM) training, were discussed. The participants reported being more attentive to their urinary habits after the educational program; some of them had incorporated exercises for the PFM. There were also an increasing number of users referred to the physiotherapy care service. Therefore, the project successfully educated the employees of the PCU for their own care and allowed the implementation of UI preventative and treatment programs in this unit. This experience may be helpful to other professionals when implementing the physical therapy assistance for women with UI in PCU.
[Show abstract][Hide abstract] ABSTRACT: This study aimed to investigate obstetrical, neonatal, and clinical predictors of stress urinary incontinence (SUI) focusing on pelvic floor muscle (PFM) strength after vaginal delivery.
A cross-sectional study was used, and potential predictors of SUI were collected 5-7 months postpartum on 192 primiparous women. Predictors that reached significance in the bivariate analysis were entered into the Classification and Regression Tree that identified interactions among them and cutoff points to orient clinical practice.
PFM strength was the strongest predictor of SUI. A combination of PFM strength ≤ 35.5 cmH(2)O, prior SUI, newborn weight > 2.988 g, and new onset of SUI in pregnancy predicted SUI. The model's accuracy was high (84%; p = 0.00).
From the four predictors identified, three are modifiable by physical therapy. This could be offered to women targeting at PFM strength >35.5 cmH(2)O at the postpartum as well as at the prevention of SUI before and during pregnancy.
Full-text · Article · Mar 2012 · International Urogynecology Journal
[Show abstract][Hide abstract] ABSTRACT: OBJETIVOS: determinar a prevalência de fatores obstétricos associados à posição de parto vaginal (PPV) vertical ou horizontal; investigar correlações entre PPV e fatores obstétricos, bem como sua influência sobre as características neonatais. MÉTODOS: foi realizado um estudo de corte transversal. A amostra foi composta por 176 mulheres primíparas que realizaram parto vaginal, entre julho/2006 e fevereiro/2007. Foi investigada a correlação entre PPV e as seguintes variáveis obstétricas: ocorrência e grau de laceração perineal espontânea, episiotomia, sutura perineal, uso de ocitocina e instrumentação cirúrgica. Os neonatos foram classificados quanto à idade gestacional, peso, estatura, perímetro cefálico e Apgar 1º e 5º minutos. Teste qui quadrado foi aplicado para investigar correlação entre PPV e variáveis obstétricas e o teste t-student para investigar a influência da PPV nas características neonatais. RESULTADOS: não foi observada correlação entre PPV e sutura perineal, laceração perineal, uso de ocitocina, episiotomia e utilização de instrumentação cirúrgica (uso de fórceps ou vácuo-extrator). Houve correlação entre PPV e episiotomia e maior prevalência de episiotomia na posição horizontal. Não houve influência da PPV nas características neonatais. CONCLUSÕES: houve maior ocorrência de episiotomia na posição de parto horizontal, embora ambas as posições de parto tenham sido satisfatórias para os neonatos.
Preview · Article · Dec 2009 · Revista Brasileira de Saúde Materno Infantil
[Show abstract][Hide abstract] ABSTRACT: Objectives: to determine the prevalence of obstetric factors associated with vaginal birth position (VBP)- vertical or horizontal; to investigate correlations between VBP and obstetric factors and neonatal characteristics. Methods: a cross-sectional study was carried out. The sample comprised 176 primiparous women who had given birth vaginally, between july 2006 and february 2007. The correlation was investigated between VBP and the following obstetric variables: occurrence and severity of spontaneous perineal lacerations, episiotomy, perineal suture, the use of oxytocin and surgical instruments. The newborns were characterized according to gestational age, weight, height, head circumference and one- and five-minute Apgar. The chi-squared test was used to investigate the correlation between VBP and obstetric variables and Student's t-test to investigate differences in neonatal characteristics according to VBP. Results: no association was found between VBP and perinealsuture, perineal laceration, the use of oxytocin, episiotomy or the use of surgical instruments (forceps or vacuum-extractor). There was a correlation between VBP and episiotomy and a greater prevalence of episiotomy for the horizontal position. VBP had no influence on the characteristics of the newborn. Conclusions: episiotomy was more prevalent in cases of horizontal birth position, although both birth positions are satisfactory as far as the newborn is concerned.
No preview · Article · Oct 2009 · Revista Brasileira de Saúde Materno Infantil